BACKGROUND: Baseline information on human papillomavirus (HPV) prevalence and type distribution is highly desirable to evaluate the impact of prophylactic HPV vaccines in the near future. METHODS: A meta-analysis was performed of studies published between 1995 and 2009 that used polymerase chain reaction or Hybrid Capture 2 for HPV detection in women with normal cytological findings. RESULTS: The analysis included 194 studies comprising 1016719 women with normal cytological findings. The estimated global HPV prevalence was 11.7% (95% confidence interval 11.6%-11.7%). Sub-Saharan Africa (24.0%) Eastern Europe (21.4%) and Latin America (16.1%) showed the highest prevalences. Age-specific HPV distribution presented with a first peak at younger ages ( /=45 years). Among the women with type-specific HPV data ([Formula: see text]) the 5 most common types worldwide were HPV-16 (3.2%) HPV-18 (1.4%) HPV-52 (0.9%) HPV-31 (0.8%) and HPV-58 (0.7%). CONCLUSIONS: Although the prevalence of HPV in women with normal cytological findings is high and variable across world regions HPV types 16 18 31 52 and 58 are consistently found among the 10 most common types in all of them. These results represent the most comprehensive assessment of HPV burden among women with normal cytological findings in the pre-HPV vaccination era worldwide.

Cervical Human Papillomavirus Prevalence in 5 Continents: Meta-Analysis of 1 Million Women with Normal Cytological Findings

Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)60367-5.pdf

Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential

https://researchonline.lshtm.ac.uk/1367702/1/1-s2.0-S0140673613620358-main.pdf

Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal).

Infections with human papillomavirus (HPV) are common and transmitted by direct contact. Although the great majority of infections resolve within 2 years, 13 phylogenetically related, sexually transmitted HPV genotypes, notably HPV16, cause - if not controlled immunologically or by screening - virtually all cervical cancers worldwide, a large fraction of other anogenital cancers and an increasing proportion of oropharyngeal cancers. The carcinogenicity of these HPV types results primarily from the activity of the oncoproteins E6 and E7, which impair growth regulatory pathways. Persistent high-risk HPVs can transition from a productive (virion-producing) to an abortive or transforming infection, after which cancer can result after typically slow accumulation of host genetic mutations. However, which precancerous lesions progress and which do not is unclear; the majority of screening-detected precancers are treated, leading to overtreatment. The discovery of HPV as a carcinogen led to the development of effective preventive vaccines and sensitive HPV DNA and RNA tests. Together, vaccination programmes (the ultimate long-term preventive strategy) and screening using HPV tests could dramatically alter the landscape of HPV-related cancers. HPV testing will probably replace cytology-based cervical screening owing to greater reassurance when the test is negative. However, the effective implementation of HPV vaccination and screening globally remains a challenge.

Carcinogenic human papillomavirus infection.

https://www.who.int/reproductivehealth/publications/general/lancet_2.pdf

Sexual behaviour in context: a global perspective.

Male pseudohermaphroditism, a syndrome defined by inadequate differentiation of male genitalia in 46, XY patients, is caused by steroid 5-alpha-reductase 2 deficiencies, an uncommon ailment. Here, we discuss the case of a 13-year-old from Wardha, Maharashtra, who was identified as female by relatives and who displayed primary amenorrhea, ambiguous genitalia, and absence of breast development. Every serum hormone profile showed testosterone levels of 460ng/dl (normal), dihydrotestosterone levels of 16ng/dl (decreased), and an elevated T/DHT ratio. Chromosome analysis identified a 46, XY karyotype. A Phallus reduction and Mcindode vaginoplasty were carried out, along with clitoroplasty, orchiopexy, and gonadoplasty, and estrogen-based hormone replacement therapy was initiated. In conclusion, babies with unclear genitalia or adolescents or young adults with the recognizable phenotypic and blood hormone profiles may have 5-alpha-reductase 2 deficiencies. However, the psychological aspects put more of an emphasis on the patient's quality of life as it relates to their health, as well as their family's adjustment and their psycho-social and psycho-sexual development. Laboratory findings: 460ng/dl testosterone (normal), dihydrotestosterone 16ng/dl (decreased); increased T/DHT ratio. Abdominopelvic - USG: no internal female structures. Urethrocystoscopy: male urethra poorly developed prostate, blind-ending vagina. large long-term gender outcome and quality of life questionnare data a sound empirical for identifying the key variables influencing assignment

Dhaval Patel

Papers

Sexual behaviour in context: a global perspective.

Differences of sex development (DSD) in 46XY, 5-alpha-reductase-2 deficiency patient for vaginoplasty: A case report